| NUMBER |
FORM TITLE |
| ARB |
Hiring Confirmation Letter (Sample Document) |
| ASD 05 |
Travel Advance Request |
| ASD 12 |
Duty Statement |
| ASD-HRB 14 |
Employee Check Out/Transfer Form |
| ASD-HRB 15 |
Student/Contractor Check Out/Transfer Form |
| ASD 26 |
ARB Time Report
|
| ASD 27 |
ARB Training Request Form |
| ASD 28 |
Receipt for Notice to Employee of Rights under FMLA |
| ASD 33B |
Request for Personnel Action |
| ASD 65 |
Competitive Rating Report Form |
| ASD 75 |
Exiting/Transferring ARB Employee Questionnaire |
| ASD 166 |
Catastrophic Leave Donation Record |
| ASD 177 |
Certification of Understanding of Sexual Harassment |
| ASD 178 |
Volunteer Record and Service Agreement |
| ASD 189 |
Medical Examination Form
|
| ASD 262A |
Travel Expense Claim |
| ASD/SAC/BSS 266 |
General Supply Order Form - Sacramento |
| ASD/EM/BSS 226 |
General Supply Order Form - El Monte |
| ASD-BMB 290 |
Employee Acknowledgement Reporting Use of State Vehicles for Commuting |
| ASD-BMB 292 |
Form 5 - Business Services Requests |
| ASD-HRB 86 |
Training and Development Assignment Plan |
| ASD-HRB 137 |
Monthly Report - Use of State Vehicles for Commuting |
| ASD-HRB 191 |
Alternate Work Week Schedule Agreement |
| ASD-HRB 225 |
Authorization to Release Information |
| ASD-HRB 246 |
Reduced Work Time Agreement |
| ASD-HRB 248 |
Request for Voluntary Personal Leave Program (VPLP) |
| ASD-HRB 271 |
Request for Examination |
| ASD-HRB 273 |
Excluded Employee Leave Buy Back Election Request |
| ASD-HRB 279 |
Staff Services Analyst (General) Request for Transfer Exam |
| ASD-HRB 281 |
Mentee Application |
| ASD-HRB 288 |
ARB Mentor/Mentee Evaluation Form |
| ASD-HRB 291 |
Ergonomic Assessment Request |
| ASD-HRB 296 |
Supplemental Time Off |
| ASD-OHR 205 |
Employment Reference Questions |
| ASD-OHR 220 |
Job Opportunity Bulletin |
| ASD-OHR 223 |
Hire Above Minimum for Extraordinary Qualifications |
| ASD-OHR 224 |
Official Personnel File Review Sheet |
| ASD-OHR 238 |
Position Justification Form |
| ASD-MSB 200 |
Request for Reasonable Accommodation |
| ASD-MSB 256 |
Language Services Request |
| ASD-MSB 284 |
Bilingual Skills Questionnaire Form |
| ASD-MSB 289 |
Incident Report |
| ASD-PMB 207 |
First Aid Injury/Illness Report |
| ASD-PMB 208 |
Acknowledgement of Receipt of SCIF 3301 |
| DF-170 |
Request for Contract, Equipment, Acquisition& Travel Ban |
| DPA 006 |
Premium Only Plan (POP) Request for Disenrollment |
| DPA 012 |
Special Act/SpecialService Award Recommendation |
| DPA 025 |
Affidavit for Economic Dependent Children |
| DPA 352 |
FlexElect Reimbursement Claim Form |
| DPA 680 |
Affidavit for Domestic Partners Being Claimed as Economic Dependents |
| DPA 681 |
Pre-Tax Parking/Third-Party Administrator/Reimbursable Account Claim |
| DPA 682 |
Pre-Tax Parking/Third-Party Administrator/Reimbursable Account Enrollment |
| DPA 689 |
COBRA Election Form |
| DPA 690 |
Verification of Total State Service |
| DPA 875 |
Annual Leave Election Form |
| EO-OIS |
Acceptable Internet Use |
| EO-OIS 01 |
Request for Employee Technology Services |
| EO-23 |
Peer Recommendation for Superior Accomplishment Award Nomination |
| EO-24 |
Voluntary Supplemental Performance Evaulation |
| FORM 700 |
Statement of Economic Interest |
| FORM I-9 |
Employment Eligibility Verification (I-9) |
| FORM I-129 |
Petition for a Nonimmigrant Worker Form |
| FORM W-4 |
Form W-4 (Personal Withholding & Adjustments) |
| INF 1101 |
Authorization for Release of Driver Record Information |
| PERS |
CalPERS Retirement Planning Workshop Reservation Form |
| PERS-BSD 241 |
Beneficiary Designation Form (CalPERS) |
| PERS-PRS 221 |
CalPERS Address Change Authorization Form |
| PERS-PUB 43 |
Service Retirement Application |
| PSD-21 |
Financial Planning Seminar Registration Form |
| STD 242 |
U.S. Savings Bonds Purchase/Deduction Authorization |
| STD 243 |
Designation of Persons Authorized to Receive Warrants |
| STD 261 |
Authorization to Use Privately Owned Vehicles on State Business |
| STD 278 |
Superior Accomplishment Gift or Cash Award Recommendation |
| STD 436 |
Duplicate Wage and Tax Statement Request |
| STD 457 |
CSU Student Payroll Action Request |
| STD 610 |
Health Questionnaire with Physicians Report |
| STD 618 |
Benefit Option Selection |
| STD 618S |
Industrial Disability Leave with Supplementation Benefits Information & Option Selection Form |
| STD 619 |
Industrial Disability Benefits Information |
| STD 630 |
Employee Contract Grievance |
| STD 631 |
Excluded Employee Grievance |
| STD 636 |
Report of Performance for Probationary Employee |
| STD 637 |
Individual Development Plan (IDP) |
| STD 645 |
Employee Suggestion Form |
| STD 645A |
Suggestion Evaluation Report |
| STD 677 |
Request for Nondisclosure of Employee Home Address |
| STD 678 |
State Application Form |
| STD 686 |
Employee Action Request |
| STD 689 |
Oath of Allegiance & Declaration of Permission to Work for Persons Employed by State of California |
| STD 692 |
Dental Plan Enrollment Authorization |
| STD 698 |
Life Insurance Enrollment Authorization |
| STD 699 |
Direct Deposit Enrollment Authorization |
| STD 700 |
Vision Plan Enrollment Authorization |
| STD 701C |
Cash Option Enrollment Authorization - FlexElect Program |
| STD 701R |
Reimbursement Account Enrollment Authorization - FlexElect Program |
| STD 702 |
Consolidated Benefits Cash Enrollment Election Form |
| STD 703 |
Vision Plan Direct Payment Authorization |
| STD 897 |
Bilingual Pay Authorization |
| STD 910 |
Essential Functions Health Questionnaire |
| STD 912 |
Military Service Declaration |
| Telework |
Supervisor's Checklist |
| Telework |
Safety Home Environment Checklist |
| Telework |
Telework Plan |
CalPERS Forms and Publications Center 